Management Trends of Urethral Stricture Disease: A Two-Decade (2000-2024) Comparison between Veteran and Civilian Populations.

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-09-25 DOI:10.1016/j.urology.2025.09.030

Merlin Mamachan, Kylie Morgan, Austin Thompson, Michael Witthaus, Jagadeesh Thippeswamy, Sirpi Nakeeeran, Nannan Thirumavalavan, Kyoko Sakamoto, Mahadevan Rajasekaran

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引用次数: 0

Abstract

Objective: To evaluate trends in the prevalence of urethral stricture disease (USD) and treatment approaches within the veteran and civilian populations over the past two decades, with an emphasis on the impact of the American Urological Association (AUA) 2016 recommendations.

Methods: We accessed the medical records of 476,715 randomly selected male veterans from 2000 to 2024 using the VA Informatics and Computing Infrastructure (VINCI). Patients were identified through ICD-9 and ICD-10 codes, with urethroplasty as the primary endpoint (CPT code 53400). Additional treatments were also analyzed, including Direct Vision Internal Urethrotomy (DVIU) (CPT 52276) and Urethral Dilation (UD) (CPT 53600). Similarly, a retrospective analysis of procedures performed in the general population was conducted using electronic health record data from the TriNetX Research Network. Treatment trends were stratified by diagnosis year, comparing 2000-2016 and 2017-2024.

Results: A total of 63,810 veterans were diagnosed with USD: 47,007 (73.7%) from 2000-2016 and 16,803 (26.3%) from 2017-2024. Of these, 211 underwent urethroplasty, with a higher percentage in the earlier period (0.4%) compared to the later period (0.2%). Non-surgical treatments (DVIU & UD) remained consistent across age groups. Urethroplasty patients were younger (median age 62) than those treated non-surgically. In the general population (TriNetX data), DVIU and dilation rates declined, while urethroplasty rates remained consistent across both periods.

Conclusion: Suboptimal incorporation of urethroplasty management for USD is observed in both veteran and civilian populations. Our results suggest no significant improvement in the rates of Urethroplasty after the release of the 2016 AUA urethral stricture guidelines.

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尿道狭窄疾病的管理趋势：二十年（2000-2024）退伍军人与平民的比较

目的：评估近二十年来退伍军人和平民人群尿道狭窄疾病（USD）患病率和治疗方法的趋势，重点研究美国泌尿外科协会（AUA） 2016年建议的影响。方法：采用VA信息与计算基础设施（VINCI）检索2000 - 2024年随机抽取的476715名男性退伍军人的医疗记录。通过ICD-9和ICD-10代码确定患者，以尿道成形术为主要终点（CPT代码53400）。另外还分析了其他治疗方法，包括直接视觉内尿道切开术（DVIU）（CPT 52276）和尿道扩张（UD）（CPT 53600）。同样，利用TriNetX研究网络的电子健康记录数据，对在普通人群中进行的手术进行了回顾性分析。根据诊断年份对治疗趋势进行分层，比较2000-2016年和2017-2024年。结果：2000-2016年共有63,810名退伍军人被诊断为USD: 47,007(73.7%)， 2017-2024年为16,803（26.3%）。其中，211例接受了尿道成形术，前期比例（0.4%）高于后期比例（0.2%）。非手术治疗（DVIU和UD）在各年龄组保持一致。尿道成形术患者比非手术患者更年轻（中位年龄62岁）。在一般人群中（TriNetX数据），DVIU和扩张率下降，而尿道成形术率在两个时期保持一致。结论：在退伍军人和平民中均观察到合并尿道成形术治疗美元的不理想情况。我们的研究结果表明，在2016年AUA尿道狭窄指南发布后，尿道成形术的发生率没有显著提高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.